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Infection Control in the Health Care Setting

By: DeAnna Looper RN, CHPN, CHPCA Chief Corporate Clinical Consultant, Legal Nurse Consultant, HPNA Approved Educator, ELNEC Certified Trainer, Certified Grief Recovery Specialist.

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Learning Objectives

• Describe the adverse affects of infections

• Describe common types of infections

• Describe the causes of infections

• Describe risk factors for infections

• Describe common signs & symptoms of infections

• Describe ways to reduce infections

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Adverse Affects of Infections

• Impede quality of life

• Increase in pain levels

• Lead to serious illness

• Financially crippling

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Infections in LTC Facilities

• 1.6 to 3.8 million infections occur annually in LTC.

• Rates of death in residents 0.04 to 0.71 per 1000 resident days.

• Pneumonia is the leading cause of death

• Infections are the leading reason for transferring residents to hospitals.

• Financial loss to the LTC facility

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Microorganisms that cause Infections

• BacteriaStaphylococcus – common in woundsStreptococcus – common in respiratory tractE-Coli-commonly caused by food contamination

• Virus Colds, Influenza, HIV, Hepatitis

• Fungus & parasitesYeast, skin and nail infections

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Spreading of Infections• Chain of Infection

(How it is passed)

• Causative Agent

• Reservoir of the Agent

• Portal of Exit

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Spreading of Infection• Route of Transmission

• Portal of Entry

• Susceptible Host

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Common Risk Factors• Poor nutritional status

• Emotional stress

• Very young

• Very old

• Weakened by illness or chronic disease

• Medications

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Early Signs of Infection

• Fever

• Malaise

• Elevated white count (on routine CBC)

• Complaints from resident/patients of “not feeling well”

• Loss of appetite

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Localized Signs and Symptoms

• Redness/discoloration

• Warmth/heat

• Streaking (not the one Ray Stevens referred to)

• Draining or pus / Color of the drainage

• Swelling, pain, or tenderness

• Foul odor

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Systemic Signs and Symptoms• Nausea and vomiting

• Diarrhea

• Labored breathing

• Sweating / Chills

• Enlarged Lymph Nodes

• Mental Status Changes

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Preventing or Reducing Infections

• Standard precautions-Follow universal precaution methods

• Alcohol Gel stations in addition to hand washing

• Use disinfection cleaning procedures

• Healthy staff

• Hand washing

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Preventing or Reducing Infections• Encourage staff with an illness to stay home

• Cover mouth when cough or sneeze

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The Golden Ticket

• Hand washing is the “Golden Ticket” to preventing infections.

• Wash with soap and water whenever your hands are visibly soiled

• Wash hands before and after eating, drinking, smoking or even placing a piece of chewing gum in mouth.

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Hand Washing –The Golden Ticket• Before and after using the restroom

• After removing gloves

• At the start and finish of your shift

• Touching contaminated equipment

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Hand Washing 101• Wet first with warm water

• About 5cc of soap (half dollar size)

• Rub hands together for 15-30 seconds

• Cover all surfaces of the hands and fingers• Rinse thoroughly• Dry with paper towels• Use paper towel to

• turn off water and • to open the door• Discard in nearest trash can

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Hand Sanitizer Use 101

• Apply 2-3 ml of an alcohol sanitizer (quarter size)

• Rub hands together

• Cover all surfaces of your hands and fingers

• Include areas around and under fingernails

• Continue rubbing hands together until alcohol dries 10 – 15 seconds

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Remember Your PPE

• Gloves

• Gowns

• Eye wear

• Splash shields

• Shoe and hair covers

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Q & A

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References• WHO World Health Organization. “Save Lives-Clean

your hands” http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf. Retrieved: 22 July, 2013.

• Encyclopedia Britannia. “Definitions” http://www.britannica.com. Retrieved 23 July, 2013

• CDC –Centers for Disease Control. “Handwashing: Clean Hands Save Lives” http://www.cdc.gov/handwashing/. Retrieved 23, July 2013

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References• Chicago Journals. Volume 29. No. 9. September

2008. “Infection Control and Hospital Epidemiology” www.JSTOR.org/stable/10.1086/592416. Retrieved: 22, July 2013.

• Ha’o Schneider, Gloria, The 800 Seniors.com Blog. “Infection Control in Skilled Nursing and Assisted Living”, May 13, 2011. http://seniorassistedliving.wordpress.com/?s=Infection+Control+ Retrieved 23, July 2013.

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References• Carter, Pamela J. “Lippincott's Textbook for Nursing

Assistants: A Humanistic Approach to Caregiving” March 1, 2011. Print.

• John Hopkins Medicine. “Hospital Epidemiology & Infection Control” www.hopkinsmedicine.org/heic.

• Retrieved: 23 July 2013